A large-scale Spanish clinical trial has found that simple lifestyle changes like eating a Mediterranean-style diet with fewer calories, engaging in regularphysical activity, and receiving weight management support can lower the risk of developingtype 2 diabetesby 31%. The study, PREDIMED-Plus, is the largest nutrition trial ever conducted in Europe and was recently published in theAnnals of Internal Medicine. Led by the University of Navarra and supported by more than 200 researchers from 22 institutions, PREDIMED-Plus followed 4,746 overweight or obese adults aged 55–75, all withmetabolic syndromebut no previous history ofcardiovascular diseaseordiabetes. Participants were divided into two groups: one adopted a calorie-reduced Mediterranean diet, engaged in moderate exercise (such as brisk walking and strength training), and received professional counseling; the other group followed a traditional Mediterranean diet with no calorie restrictions or exercise guidance. Over six years, the intervention group not only lowered their diabetes risk significantly but also experienced greater weight loss, on average, 3.3 kg and 3.6 cm from the waist, compared to just 0.6 kg and 0.3 cm in the control group. This equated to preventing roughly three new diabetes cases per 100 participants. “Diabetes is the first solid clinical outcome for which we have shown, using the strongest available evidence, that the Mediterranean diet with calorie reduction, physical activity, and weight loss is a highly effective preventive tool,” said Professor Miguel Ángel Martínez-González, principal investigator of the project. Experts noted that while medications for obesity and diabetes are making headlines, this study underscores the powerful effect of modest, sustained lifestyle changes. Reference:Miguel Ruiz-Canela, Dolores Corella, Miguel Ángel Martínez-González, et al. Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes: A Secondary Analysis of a Randomized Controlled Trial. Ann Intern Med. [Epub 26 August 2025]. doi:10.7326/ANNALS-25-00388